World's First Surgical Technique of Lower-Dose Radioisotope Brachytherapy 2020.03.02

World’s first surgical technique for lower-dose radioisotope brachytherapy to treat prostate cancer was developed by Dr. Park, Dong Soo of Urology, CHA Bundang Medical Center

The world’s first surgical technique, reducing the dose of radioisotope in brachytherapy procedure, was developed by a research team (Dr. Shin, Hyun Soo of Radiation Oncology and Dr. You, Young Dong of Urology) led by Dr. Park, Dong Soo of Urology. This novel brachytherapy, which maximized the treatment effect and drastically reduced complications, appeared in the ‘Scientific Reports’, a sister journal of the world's leading scientific journal Nature.

Brachytherapy technique reducing radioisotope dose by 15% brings about maximum effect with minimal side effects and complications
The research team led by Dr. Park, Dong Soo comparatively analyzed the cancer treatment results of varying degrees with reduction of radioisotope administered to approximately 500 patients who underwent Brachytherapy at the Department of Urology of CHA Bundang Medical Center. The results of analysis showed a decline in the side effects, such as dysuresia and rectal complication, in the group that underwent surgery involving a 15% reduction in the dose rate of radioisotope.
Urinary state, rectum-related symptoms, erectile capacity, etc., were comparatively analyzed in the patients divided into 145Gy dose group and 123.5 Gy dose group that underwent surgery involving the radiation delivered to the target volume of interest at a dose reduced by 15%. It was found that the urinary discomfort score was 15.9 points in the group that underwent surgery at a reduced dose rate of radioisotope, which was 3.3 points lower than the group administered with slightly higher dose rate of radioisotope(19.2 points). Moreover, a decrease in complications, such as rectal complications, etc., was observed in the group in which the radioactive sources were placed at a lower dose rate. The cancer treatment rate and erectile capacity in the group of patients, administered lower dose of radioisotope in the surgery, were found to be same as those of the group of patients who underwent surgery involving higher dose of isotope in the conventional way.

A new protocol presented on the brachytherapy treatment for prostate cancer

The international treatment guidelines, such as the National Comprehensive Cancer Network (NCCN), recommends the prostatectomy (robot-assisted surgery), external beam radiotherapy, and brachytherapy for treatment of prostate cancer in its incipient stage. Particularly, brachytherapy has the advantage that the survival rate is same as that of patients who underwent prostatectomy and that it does not require removal of prostate, leading to lower incidence of complications such as urinary incontinence and erectile dysfunction, and furthermore, allows the patients to return to their routines of everyday life on the following day of the procedure.
However, brachytherapy has the downside that dysuresia occurs in patients for about 8 months and up to 2 years due to the effect of radioisotope implanted in the prostate. In response to that, the research team led by Dr. Park, Dong Soo developed a technique for reducing the radioisotope dose by 15% based on the calculation method allowing the treatment effect of radioisotope to be kept to maximum, inspired by the idea that the side effects of brachytherapy was closely associated with the dose of radioisotope placed in the prostate.

Lower radiation dose based on a new method for shrinking the prostate gland

The research team led by Dr. Park, Dong Soo was inspired by the idea that the inhibition of male hormone would lead to a reduced prostate size. On the very day of brachytherapy procedure, patients were administered the injections inhibiting the male hormone to shrink the prostate for 3 months. The injection was intended to decrease the area of prostate cancer by shrinking it, thus making it possible to maintain the effect of treatment even when the dose of radioisotope was slashed. In addition, the injection, inhibiting the male hormone only over short-term, has almost no side effect and allows the male hormone level to recover to normal level about 6-8 months later. This research, which resulted in a breakthrough surgical procedure, laid a new foundation for not only maximizing the treatment effect with lower dose rate of radioisotope in brachytherapy procedure but also increasing the patient satisfaction even further, thus presenting a new treatment protocol. The research team led by Dr. Park, Dong Soo is poised to move ahead with the research and development in an endeavor for treatment and better quality of life of patients.

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